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A compelling vision with patient and workforce safety as a core value is essential to achieving safe care. Zero harm
is the aspirational “North Star.” Healthcare CEOs demonstrate their belief that safety is a primary, non-negotiable
goal by working with their Board, clinical leadership, and workforce to develop such a vision, to embed it in their
organization, and to demonstrate their commitment and energize frontline workers through direct involvement in
safety activities (NPSF 2015).
The first step for a CEO in creating this vision is to understand, acknowledge, and communicate the current state
of their organization. A successful vision statement may be developed by top management and shared with the
organization, or created in partnership with the workforce. The key is that the vision statement must encompass
all organizational interests and engage the entire workforce. Visions that offer long-term perspective and include a
degree of difficulty or stretch are often the most powerful. Finally, a vision statement should be clear and concise,
allowing it to be easily remembered, repeated, and communicated (Kantabutra and Avery 2010).
Leaders must work with their teams, in direct partnership with physicians, nurses, and other clinical and non-clinical
leaders, to assess the internal and external landscape of their organization. They must consider safety metrics,
clinicians’ attitudes and perceptions, patient and family experiences, and current practices, as well as trends and
events that affect or might affect the healthcare industry. Landscape analysis is often accomplished through tactics
including focus groups, safety culture surveys, safety rounds, analysis of safety metrics and reporting, and other
diagnostic approaches. As one team of management researchers tell us, “The best way to lead people into the
future is to connect with them deeply in the present” (Kouzes and Posner 2009). Understanding and communicating
the current state enables leaders to connect and work with their teams and clinical experts to create a shared vision
that can inspire everyone within the organization and the community.
While it is important to get input and buy-in from all levels when developing a vision, CEOs must be the ones to
define and model the vision. Leaders at every level need to be visible in their commitment to patient and workforce
safety and vocal about supporting actions that align with the organizational vision.